Expanded Disability Status Scale

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Original Editor - Memoona Awan
Top Contributors - Memoona Awan and Kim Jackson

Purpose

A neurologist John Kurtzke in 1983 designed a scale called Expanded Disability Status Scale (EDSS) as an advance from his previous 10 step Disability Status Scale (DSS). It is used to evaluate disability in multiple sclerosis and monitoring changes in the level of disability over time.

Technique

The EDSS quantify disability of MS patient based on neurological assessment by categorizing sign and symptoms in eight functional systems (FS). Furthermore, it comprises the ability to execute activities of daily living (ADL) and ambulatory function.

1. Visual functions: visual field, visual acuity, scotoma and disc pallor.
2. Brainstem functions: problems with speech, swallowing and nystagmus.
3. Pyramidal functions: muscle weakness or difficulty moving limbs
4. Cerebellar functions: ataxia, loss of balance, coordination or tremor.
5. Sensory functions: numbness or loss of function.
6. Bowel and bladder functions: urinary retention, urgency and bowel dysfunction
7. Cerebral functions: problems with thinking and memory
8. Ambulation score.

Note 1: EDSS steps 1.0 to 4.5 refer to patients who are fully ambulatory and the precise step number is defined by the Functional System score(s). EDSS steps 5.0 to 9.5 are defined by the impairment to ambulation and usual equivalents in Functional Systems scores are provided. Note 2: EDSS should not change by 1.0 step unless there is a change in the same direction of at least one step in at least one FS.

An overall score range from 0 -10 in ordinal scale, where 0 is normal neurological examination and 10 is death due to MS.

Scores from 0 to 4.0 are determined by FS scores, which means that in this range the EDSS is essentially a measure of impairment. Scores from 4.0 higher basically address disability. Ambulatory function and the use of walking aids heavily determine the range of 4.0–7.0, and scores between 7.0 and 9.5 are largely determined by the ability to carry out ADL.

https://www.youtube.com/watch?v=j9UCoLNu6_A&t=13s

https://www.youtube.com/watch?v=v9sFiM_lkJ4

References

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